2014 Black Book. Financial Solutions: Accountable Care Organizations. Top Ranked Financial Services & Software: Value-Based Care & ACOs

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1 2014 Black Book Financial Solutions: Accountable Care Organizations Top Ranked Financial Services & Software: Value-Based Care & ACOs Black Book Rankings. This report is a licensed product. Page 1

2 2014 Black Book Financial Systems and Services: Value-Based Care Solutions Top Ranked Financial Services & Software: Value-Based Care & ACOs Black Book annually evaluates leading healthcare/medical software and service providers across 18 operational excellence key performance indicators completely from the perspective of the client experience. Independent and unbiased from vendors influence, over 400,000 healthcare IT users are invited to contribute. Suppliers also encourage their clients to participate to produce current and objective customer service data for buyers, analysts, investors, consultants, competitive suppliers and the media. For more information or to order customized research results, please contact the Client Resource Center at or Reproduction of this publication in any form without prior written permission is forbidden. The information contained herein has been obtained from sources believed to be reliable. Black Book disclaims all warranties as to the accuracy, completeness or adequacy of such information. Black Book shall have no liability for errors, omissions or inadequacies in the information contained herein or for interpretations thereof. The reader assumes sole responsibility for the selection of these materials to achieve its intended results. The opinions expressed herein are subject to change without notice. Black Book offers unrivaled objectivity and credibility. At a time when alliances between major consultancies and suppliers have clouded the landscape, and advice is difficult to discern from the hype, Black Book reports may be your greatest assurance. Black Book remains resolutely independent. We have no incentive to recommend specific outsourcing, managed services and software vendors. Our only allegiance is to help you achieve the results you want with the best possible solution. For more information, visit Published August 2014 Black Book Rankings. This report is a licensed product. Page 2

3 Black Book Financial Systems, Software & Outsourced Services Survey overview In Q1 through Q3 2014, the Black Book Rankings financial systems division client/user survey investigated 210 financial services and software vendors utilized by validated users nationwide for ings and an additional 2,775 respondents in pre-use, implementation, system decision-making or purchased but not yet installed status in various hospital and physician organizations. 106 of the 606 current private and public ACOs participated in the Financial Services and Software support survey, as did 468 hospital and physician provider organizations in the pre-aco stages of development. 485 hospital and physician organizations not yet establishing ACO or value-based initiatives also participated in the polling and based their perceptions of the evaluated software and services on current performance of the solutions in their respective settings. A total of 1050 executives and users were validated in the Black Book 2014 survey. BLACK BOOK METHODOLOGY How the data sets are collected Black Book collects ballot results on 18 performance areas of operational excellence to vendors by hospital financial product and service lines. The gathered data are subjected immediately to an internal and external audit to verify completeness and accuracy and to make sure the respondent is valid while ensuring that the anonymity of the client company is maintained. During the audit, each data set is reviewed by a Black Book executive and at least two other external firm staff members. In this way, Black Book's clients are able to clearly see how a vendor is truly performing. The 18 criteria on operational excellence are subdivided by the client's industry, market size, geography and function outsourced, and reported accordingly. Situational and market studies are conducted on areas of high interest such as electronic health records, e- Prescribing, Health Information Exchange, Accountable Care organization, hospital software, services providers, educational providers in e-health, benchmarkers and advisors. These specific survey areas range from four to 20 questions or criteria each. Understanding the statistical confidence of Black Book data Statistical confidence for each performance rating is based upon the number of organizations scoring the electronic medical and health records service. Black Book identifies data confidence by one of several means: Top-5-ed vendors must have a minimum of ten unique clients represented. Broad categories require a minimum of 20 unique client ballots. Data that are asterisked (*) represent a sample size below required limits and are intended to be used for tracking purposes only, not ing purposes. Performance data for an asterisked vendor's services can vary widely until a larger sample size is achieved. The margin of error can be very large and the reader is responsible for considering the possible current and future variation (margin of error) in the Black Book performance score reported. Vendors with over 20 unique client votes are eligible for top 5 ings and are assured to have highest confidence and lowest variation. Confidence increases as more organizations report on their outsourcing vendor. Data reported in this form are shown with a 95% confidence level (within a margin of 0.25, 0.20 or 0.15, respectively). Black Book Rankings. This report is a licensed product. Page 3

4 Raw numbers include the quantity of completed surveys and the number of unique organizations contributing the data for the survey pool of interest. Who participates in the Black Book Ranking process Over 31,000 hospital financial and information technology leaders and other users ing from hospital executives, clinicians, IT specialists and front-line implementation veterans are invited to participate in the 2014 annual Black Book health initiative satisfaction surveys. Non-invitation receiving participants must complete a verifiable profile, utilize valid corporate address and are then included as well. The Black Book survey web instrument is open to respondents and new participants each year from March 1 to June 5 online to evaluate financial software and services, and by paper ballot if requested. Only one ballot per corporate address is permitted and changes of ballots during the open polling period require a formal request process to ensure integrity. Telephone surveying supports the process additionally as required for validations. FINANCIAL SYSTEMS, SOFTWARE AND OUTSOURCED SERVICES VALUE BASED & ACCOUNTABLE CARE SURVEY RESPONDENTS HOSPITAL & ACO FINANCIAL LEADERS PARTICIPATING IN BLACK BOOK SURVEY AGGREGATE SATISFACTION RATE FINANCIAL SOFTWARE VENDORS AGGREGATE SATISFACITON RATE OUTSOURCED SERVICE VENDORS 30% 37% 71% 80 % Individual vendors can be examined by specific indicators on each of the main functions of vendors as well as grouped and summarized subsets. Details of each subset are contained so that each vendor may be analyzed by function and end-to-end hospital patient accounting services collectively. Black Book Rankings. This report is a licensed product. Page 4

5 Figure 1: ACO & Value-based care organizations Financial Solutions are defined as being comprised of four surveyed functional groups or services components Figure 2: Key to raw scores Deal breaking dissatisfaction Does not meet expectations Cannot recommend vendor Neutral Meets/does not meet expectations consistently Would not likely recommend vendor Satisfactory performance Meets expectations Recommends vendor Overwhelming satisfaction Exceeds expectations Highly recommended vendor Figure 3: Color-coded stop light dashboard scoring key Green (top 10%) scores better than 90% of ACO support vendors. Green coded vendors have received constantly highest client satisfaction scores Clear (top 33%) scores better than 67% of ACO support vendors. Well-scored vendor which have middle of the pack results to 8.70 Yellow scores better than half of ACO support vendors. Cautionary performance scores, areas of improvement required to 7.32 Red scores worse than 66% of ACO support vendors. Poor performances reported potential cause for service and contractual cancellations. Less than 5.79 Black Book Rankings. This report is a licensed product. Page 5

6 Stop Light Scoring Key Scoring key Overall Q6 criteria CAPITATION AND RISK 5 1 Value Based Solutions and Services Inc Overall this references the final position of all 18 criteria averaged by the mean score collectively. This vendor ed fifth of the 20 competitors. Criteria refers to the number of the question or criteria surveyed. This is the sixth question of the 18 criteria of which this vendor ed first of the 20 vendors analyzed positioned only on this particular criteria or question. Each vendor required ten unique client ballots validated to be included in the top ten s. name of the ACO support services and or software vendor. Subsections each subset comprises one-fourth of the total ACO/Value-based financial services and software support vendor mean at the end of this row, and includes all buyers and users who indicate that they contract each respective value-based care functional subsection with the supplier, specific to their physician enterprise or hospital. congruent with the criteria, the mean is a calculation of all four subsets of ACO support functions surveyed. As a final ing reference, it includes all market sizes, specialties, delivery sites and geographies. Top Electronic Medical Records/Electronic Health Records Vendors Published 11/2011 Black Book Rankings. This report is a licensed product. Page 6

7 Overall KPI Leaders: ACO & VALUE-BASED CARE FINANCIAL SERVICES & SOFTWARE SOLUTIONS 2014 Summary of criteria outcomes ACCOUNTABLE CARE & VALUE-BASED SUPPORT SERVICES, SOFTWARE & OUTSOURCED SOLUTIONS Total number one criteria s Vendor Overall 8 CONIFER HEALTH 1 3 OPTUM 4 1 PHYTEL 3 1 ADVISORY BOARD 2 1 HEALTH CATALYST 6 1 MCKESSON RELAYHEALTH 7 1 CERECONS 9 1 COVISINT 13 1 NEXTGEN 15 Black Book Top Patient Accounting Software and Services Vendors, Large Hospitals and Hospital Systems/Chains IDNs ACOs Published June 2014 Black Book Rankings. This report is a licensed product.

8 Overall KPI Leaders: ACO & VALUE-BASED CARE FINANCIAL SERVICES & SOFTWARE SOLUTIONS Summary of criteria outcomes Top score per individual criteria Top score per individual criteria Question Criteria Vendor Overall 1 Vendor overall solution preference/aco industry recommendations CONIFER HEALTH 1 2 Innovation OPTUM 4 3 Training CONIFER HEALTH 1 4 Client relationships and cultural fit HEALTH CATALYST 6 5 Trust, Transparency, Accountability CONIFER HEALTH 1 6 Breadth of offerings, client types, delivery excellence OPTUM 4 7 Deployment and implementation CONIFER HEALTH 1 8 Customization PHYTEL 3 9 Integration and interfaces CONIFER HEALTH 1 10 Scalability, client adaptability, flexible pricing CERECONS 9 11 Compensation and employee performance MCKESSON RELAYHEALTH 7 12 Reliability CONIFER HEALTH 1 13 Brand image and marketing communications OPTUM 4 14 Marginal value adds COVISINT Viability and Managerial Stability OPTUM 4 16 Data security and backup services CONIFER HEALTH 1 17 Support and customer care NEXTGEN Best of breed technology and process improvement CONIFER HEALTH 1 Black Book Top Patient Accounting Software and Services Vendors, Large Hospitals and Hospital Systems/Chains IDNs ACOs Published June 2014 Black Book Rankings. This report is a licensed product.

9 Top ACO Financial Services Support Vendors raw scores by Key Performance Indicator 2014 Rank Vendor Q1 Q2 Q3 Q4 Q5 Q6 Q7 Q8 Q9 Q10 Q11 Q12 Q13 Q14 Q15 Q16 Q17 Q18 1 CONIFER HEALTH ADVISORY BOARD PHYTEL OPTUM MEDECISION HEALTH CATALYST MCKESSON RELAYHEALTH AETNA MEDICITY CERECONS SANDLOT MEDVENTIVE ALLSCRIPTS COVISINT ALDERA NEXTGEN GSI HEALTH HEALTHCARE FIRST EPIC SYSTEMS INTELICHART ECLINICALWORKS Black Book Rankings. This report is a licensed product and requires permission to distribute Published August 2014 Page 9

10 1. Vendor overall preference by similar users of ACO (all stages of development) hospitals IDNs, physician organizations chains for vendor expertise in end-to-end financial ACO support functionalities. Organizational structure meets the needs of stakeholders or customers and stakeholder satisfaction is the most important priority. ACO financial system or services client is likely to recommend the vendor to similar sized ACO, hospital, networked physician groups, and chains/systems/networks. Overall Q1 Criteria 1 1 CONIFER HEALTH ADVISORY BOARD EPIC SYSTEMS PHYTEL HEALTH CATALYST MEDECISION OPTUM SANDLOT ALLSCRIPTS MCKESSON RELAYHEALTH Black Book Rankings. This report is a licensed product and requires permission to distribute Published August 2014 Page 10

11 2. Innovation Customers are also continuing to push the envelope for further enhancements to which the ACO financial services and software vendor is responsive. ACO clients also believe that their vendors technology is helping them manage hospitals more effectively, generate accurate records and reimbursement billings and cut their overhead in ways that were difficult or impossible to accomplish before the incumbent patient accounting systems were implemented. Vendor is responsive to make client recommendations with cutting edge improvements. Overall Q2 Criteria 4 1 OPTUM ADVISORY BOARD CONIFER HEALTH PHYTEL ALDERA MEDECISION AETNA MEDICITY SANDLOT GSI HEALTH MCKESSON RELAYHEALTH Black Book Rankings. This report is a licensed product and requires permission to distribute Published August 2014 Page 11

12 3. Training Financial services vendor leadership provides significant and meaningful training opportunities for internal employees and client staff. Leadership strives to develop technology staff, ACO client service and customer servicing consultant employees in particular. Training modules are effective and practical so that minimal post-implementation training is required on or off site. Regular updates are timely and require minimal additional training to implement. Ove9rall Q3 Criteria CONIFER HEALTH CERECONS GSI HEALTH PHYTEL HEALTH CATALYST ADVISORY BOARD ALLSCRIPTS INTELICHART OPTUM MEDVENTIVE Source: Black* Book Rankings Black Book Rankings. This report is a licensed product and requires permission to distribute Published August 2014 Page 12

13 4. Client relationships and cultural fit ACO financial services & software vendor leadership honors customer relationships highly. The relationship with the vendor elevates the customer reputation. Improving hospital financials and healthcare delivery efficiency and effectiveness are top priority of the supplier. Governance of engagement is neither complex for buyer nor does it require vendor management attention regularly. There is no regular transparency or quality issue. There are no culture clashes or misfits that threaten relationship s success or client s satisfaction. Overall Q4 Criteria HEALTH CATALYST CONIFER HEALTH PHYTEL SANDLOT ADVISORY BOARD MEDECISION OPTUM CERECONS MEDVENTIVE AETNA MEDICITY Black Book Rankings. This report is a licensed product and requires permission to distribute Published August 2014 Page 13

14 5. Trust, Accountability and Transparency Trust in enterprise reputation is important to patient accounting clients as well as prospects. Client possesses an understanding that its vendor organization has the people, processes, and resources to effectively deliver the desired business and clinical results, based on its industry reputation and past performance. There are no disconnects between promises and delivery Overall Q5 Criteria CONIFER HEALTH CERECONS MEDECISION OPTUM PHYTEL MEDVENTIVE MCKESSON RELAYHEALTH HEALTH CATALYST SANDLOT COVISINT Black Book Rankings. This report is a licensed product and requires permission to distribute Published August 2014 Page 14

15 6. Breadth of offerings, varied client settings, delivery excellence across all points of maturity among value-based services & software users ACO financials vendor offers industry recognized horizontal functionality and vertical industry applications, and manage bundled financial services such as coding and bad debt management w and developing new e-health initiatives. Vendor routinely drives operational performance improvements and results in the areas they affect. Comprehensive offerings are constructed to meet the unique needs of the client s financial systems initiatives. Breadth of vendor modules may offer comprehensive nonfinancial/clinical system services and broad modules. Overall 4 1 Q6 Criteria OPTUM AETNA MEDICITY ADVISORY BOARD CONIFER HEALTH HEALTHCARE FIRST PHYTEL MCKESSON RELAYHEALTH HEALTH CATALYST MEDECISION EPIC SYSTEMS Black Book Rankings. This report is a licensed product and requires permission to distribute Published August 2014 Page 15

16 7. Deployment and ACO/Value-based care module implementations Financial support services and systems client deploys at a pace acceptable to the client. ACO solutions eliminate excessive supervision over vendor implementations. Vendor overcomes client implementation obstacles and challenges effectively. Technical, organizational and cultural implementation obstacles are handled professionally and punctually. ACO services and software implementation time meets standard expectations. Implementations are efficient and sensitive to users specific situations which may cause delays. Overall 1 Q7 Criteria 1 CONIFER HEALTH AETNA MEDICITY HEALTH CATALYST ADVISORY BOARD ALDERA PHYTEL MCKESSON RELAYHEALTH SANDLOT MEDECISION OPTUM Black Book Rankings. This report is a licensed product and requires permission to distribute Published August 2014 Page 16

17 8. Customization Value-based care and reimbursement products and process services are customized to meet the unique needs of specific practice client purpose, processes and physician/provider/hospital models. Little resistance is encountered when changing performance measurements as clients needs vary. Extraordinary efforts are made to adapt and convert client special needs into workable solutions with efficient cost and time considerations. Financial software allows for modifications that are not costly or complex. Overall Q8 Criteria 4 10 PHYTEL ADVISORY BOARD CONIFER HEALTH CERECONS MEDECISION NEXTGEN COVISINT AETNA MEDICITY ALLSCRIPTS OPTUM Black Book Rankings. This report is a licensed product and requires permission to distribute Published August 2014 Page 17

18 9. Integration and interfaces ACO financial services and software vendor supports interfaces so information can be shared between necessary applications. Solutions are easily integrated to existing backend systems as needed and connectivity feasible. Seamless interfaces to legacy applications are performed as required for optimal functioning. Human integration and interface activities are administered precisely. Systems communicate effectively among provider groups and ancillaries. True interoperability with other healthcare organizations is factored into implementation. Overall 1 1 Q9 Criteria CONIFER HEALTH GSI HEALTH OPTUM MCKESSON RELAYHEALTH ADVISORY BOARD CERECONS MEDECISION PHYTEL COVISINT ECLINICALWORKS Black Book Rankings. This report is a licensed product and requires permission to distribute Published August 2014 Page 18

19 10. Scalability, client adaptability, flexible pricing Value-based care and ACO financial services and solutions vendor provides flexible pricing allowing the client to choose and pay for the precise functionality and services needed. Vendor Invests in significant infrastructure and has the ability to provide services to enterprise organizations. IT products and services meet the changing and varied needs of the ACO or organizational/corporate financials customer. Pricing is not rigid or shifting and meets needs of client. Overall Q10 Criteria CERECONS MEDECISION OPTUM CONIFER HEALTH ADVISORY BOARD PHYTEL ALDERA AETNA MEDICITY HEALTHCARE FIRST MEDVENTIVE Black Book Rankings. This report is a licensed product and requires permission to distribute Published August 2014 Page 19

20 11. Vendor staff expertise, compensation and employee performance ACO financial support vendor team of employees is considered top in industry for professionalism and skill. Vendor attracts and retains high performing staff. Vendor is focused on building and developing a strong employee team of producers. Employees act like owners/leaders. is moving towards leveraged pay at all levels. Vendor is using effective tools to tie performance metrics to compensation policy and compensating top leaders. Human resources-related criteria are scored from the client perspective on this indicator. Overall Q11 Criteria MCKESSON RELAYHEALTH CONIFER HEALTH SANDLOT AETNA MEDICITY ADVISORY BOARD MEDECISION PHYTEL MEDVENTIVE OPTUM EPIC SYSTEMS Black Book Rankings. This report is a licensed product and requires permission to distribute Published August 2014 Page 20

21 12. Reliability ACO/Value-based financial services and software supplier meets agreed terms as evidenced by routine, acceptable service level reporting and industry expectations. Depth and breadth of applications/solutions are acceptable in meeting client needs. Online reliability is maximized and outages/downtimes are minimized. Solid product and service capacities are demonstrated consistently. Service levels are consistently met as agreed. Services and support response is maximized by vendor team. Overall Q12 Criteria 7 10 CONIFER HEALTH ALLSCRIPTS MEDECISION ADVISORY BOARD SANDLOT PHYTEL HEALTH CATALYST HEALTHCARE FIRST AETNA MEDICITY MCKESSON RELAYHEALTH Black Book Rankings. This report is a licensed product and requires permission to distribute Published August 2014 Page 21

22 13. Brand image and marketing communications Financial services and software vendor s marketing and sales statements/pitches are accurately and appropriately represented by actual financial product and service deliverables. Image is consistent with top ACO and healthcare industry ings. Sales presentations and proposals are delivered upon and corporate integrity/honesty in marketing and business development are highly valued. image and integrity are values upheld top-down consistently. High level of relevant client communications enhances the vendor user relationship. Overall Q13 Criteria OPTUM AETNA MEDICITY HEALTH CATALYST COVISINT CERECONS CONIFER HEALTH PHYTEL ADVISORY BOARD SANDLOT ALLSCRIPTS Black Book Rankings. This report is a licensed product and requires permission to distribute Published August 2014 Page 22

23 14. Marginal value adds The ACO financial services and software vendors' cost savings are realized as generally estimated and not over-positioned or over/underestimated in ways that effect major client satisfaction or costs. Vendor offers value-adds as a practice management partner in cost savings and avoidance initiatives and creative programs through bundled financial product design. Provides true business transformation opportunities to accountable care organizations, hospital(s), affiliated physician practices and other medical settings utilizing the financial system modules. Overall Q14 Criteria COVISINT EPIC SYSTEMS PHYTEL CONIFER HEALTH ALDERA MCKESSON RELAYHEALTH AETNA MEDICITY ADVISORY BOARD NEXTGEN ALLSCRIPTS Black Book Rankings. This report is a licensed product and requires permission to distribute Published August 2014 Page 23

24 15. Viability and managerial stability Vendor s corporate viability, employee turnover, financial stability and/or cultural mismatches do not threaten relationship. Senior management and the board exemplify strong leadership principals to steward appropriate resources that impact patient accounting buyers. Client is confident of long term industry viability for this vendor based on investments, client adoption, exceptional outcomes and service levels. Field management is notably competent, stable and supportive of clients. ACO services and software vendor demonstrates and provides evidence of competent financial management and leadership. Overall Q15 Criteria ADVISORY BOARD OPTUM CONIFER HEALTH SANDLOT MCKESSON RELAYHEALTH CERECONS HEALTH CATALYST PHYTEL ALLSCRIPTS MEDVENTIVE Black Book Rankings. This report is a licensed product and requires permission to distribute Published August 2014 Page 24